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KROGER PHARMACY #014833
CH05064E Family Health Services of Darke County
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Covered Entity Details
Entity Name
Family Health Services of Darke County
Subdivision Name
Family Health Behavioral Health and Wellness
Type
HRSA-Funded Health Center
340B ID
CH05064E
Entity Address
1101 JACKSON ST STE C
Greenville, OH 45331-1183
Grant Number
H80CS00419
Participating Start Date
1/1/2017
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #014833
Pharmacy Address
200 LEASE AVENUE
GREENVILLE, OH 45331
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jared Pollick, Executive Director
(937) 548-3806
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
10/13/2023
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